Active NPI
Rafael A Hernandez, DMD
- Periodontics
- Humacao, PR
National Provider Identifier
1396848339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 2009
- Practice address
- Ave Font Martelo #53
104
Humacao, PR 00791 - Phone
- (787) 852-4475
- Fax
- (787) 285-0632
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2009 | PR | Primary |
Addresses
Primary practice location
Ave Font Martelo #53
104
Humacao, PR 00791
Mailing address
Ave Font Martelo
#53
Humacao, PR 00791
Phone (787) 852-4475
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DM10293-9 | Other | PR | STATE DRUG LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009 | PR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396848339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "AVE FONT MARTELO",
"address_2": "#53",
"city": "HUMACAO",
"state": "PR",
"postal_code": "00791",
"telephone_number": "787-852-4475",
"fax_number": "787-285-0632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AVE FONT MARTELO #53",
"address_2": "104",
"city": "HUMACAO",
"state": "PR",
"postal_code": "00791",
"telephone_number": "787-852-4475",
"fax_number": "787-285-0632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "RAFAEL",
"middle_name": "A",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PR",
"license": "2009",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE DRUG LICENSE",
"identifier": "DM10293-9",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Humacao, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.